Healthcare Provider Details

I. General information

NPI: 1568233542
Provider Name (Legal Business Name): HEATHER ANDERSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 NORTHBROOKE PLAZA DR STE 200
NAPLES FL
34119-8088
US

IV. Provider business mailing address

2515 NORTHBROOKE PLAZA DR STE 200
NAPLES FL
34119-8088
US

V. Phone/Fax

Practice location:
  • Phone: 239-325-6955
  • Fax: 239-396-7155
Mailing address:
  • Phone: 239-248-5992
  • Fax: 239-396-7155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11029635
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: